PESHAWAR: The Khyber Pakhtunkhwa government has decided to task Education Testing and Evaluation Agency (Etea) to make recruitments in medical teaching institutions, apparently after widespread allegations of violation of merit in some of the MTI-covered institutions.

On Thursday, the provincial cabinet approved a proposal by health department to make recruitments in MTIs through Etea. However, Etea will make recruitments only against lower positions while top appointments will be made as usual by the respective Board of Governors (BoG) of the MTI.

Sources said that allegations were levelled about appointments on top positions such as medical director (MD), hospital director (HD), finance director (DF) and batteries of managers working in MTIs.

The chairman of MTI-Policy Board, Prof Nausherwan Burki, told Dawn that Etea would make only non-faculty and low grade appointments in MTIs. “We discussed this with Etea. All faculty positions, senior managerial positions and positions requiring special expertise will be excluded from Etea,” he said.

Doctors want executives appointed through public service commission

The government’s proposal to involve Etea was meant to pave the way for transparency in top appointments in MTIs but BoG would continue to call the shots and make recruitments.

The teaching hospitals and their affiliated medical and dental colleges have been under the control of BoGs since the onset of Medical Teaching Institutions Reforms Act in 2015. These boards take all important decisions. Ironically, the members of BoG are nominated from private sector but they have immense powers to abolish any position, re-designate posts, which they don’t need, and use one-line budget as per their own needs without any input, interference and check by health department.

The health department manages 2,600 hospitals with 60,000employees, including doctors, paramedics, nurses and support staff in the province but it has no control over 11 MTIs, which use nearly half of the health budget.

Of late, there have been widespread allegations regarding appointments in MTIs, especially in Peshawar. In Mardan, a doctor, whose termination was ordered by chief minister from Lady Reading Hospital a few months ago, was appointed on a top position.

Likewise, there is difference in the salary structure in MTIs. Employees of MTIs have been widely criticised by doctors as DF and managers are given salaries more than that of BPS-20 officers in health department.

The representatives of doctors, who are at the forefront of protests against violation of merit in MTIs, said that there was no issue in recruitment of paramedics, nurses and Class-IV employees. They asked government to make recruitments on top positions through public service commission.

As per MTI law, the BoG appoints dean, MD, HD, DF and other managers. The board can remove them anytime. The employees of MTIs holding executive positions obey all orders of BoG just to protect their jobs.

The BoG has also the powers to extend the tenure of executives by five more years if it is satisfied with their performance. It means executives of MTIs will obey every order of BoG to get extension. There are many examples that executives got extensions.

Public health experts wonder as to why the government has been supporting MTIs despite their inability to improve healthcare services during the past 11 years. The BoG members are private people and cannot be held responsible like district health officers, medical superintendents and directors, who are public servants and can face action under relevant law.

“Empowering Etea to appoint low grade employees will have no impact. Check is needed on recruitments on top positions on which people get lucrative salaries,” say experts.

Published in Dawn, May 24th, 2026